Interpretive Handbook

Test
83094 :
Bleeding Diathesis Profile, Limited

Bleeding problems may be associated with a wide variety of coagulation abnormalities or may be due to problems not associated with coagulation (trauma and surgery as obvious examples). A partial listing of causes follows.

-Specific factor inhibitors (most commonly directed against factor VIII); factor inhibitors occur in 10% to15% of the hemophilia population and are more commonly associated with severe deficiencies of factor VIII or IX (antigen <1%). The inhibitor appears in response to transfusion therapy with factor concentrates with no correlation of occurrence and amount of therapy. Factor VIII inhibitors may occur spontaneously in the postpartum patient, with certain malignancies, in association with autoimmune disorders (eg, rheumatoid arthritis, systemic lupus erythematosus), in the elderly, and for no apparent reason.

-Other acquired causes of increased bleeding include paraproteinemia; other factor-specific inhibitors, including those against factor V, factor XI; or virtually any of the coagulation proteins.

-Acute disseminated intravascular coagulation/intravascular coagulation and fibrinolysis (DIC/ICF), which is a fairly common cause of bleeding. Bleeding can also occur in patients with chronic ICF.

Detection of the more common potential causes of abnormal bleeding (eg, factor deficiencies/hemophilia, von Willebrand disease, factor-specific inhibitors) and a simple screen to evaluate for an inhibitor or severe deficiency of factor XIII (rare).

Patient should not be receiving Coumadin or heparin. If the patient is currently on warfarin or heparin, this should be noted, as warfarin or heparin therapy can affect certain coagulation factors or assays, preclude their performance, or cause spurious results. Patient should also not be receiving fibrinolytic agents (streptokinase, urokinase, tissue plasminogen activator [tPA]).

If patient has been recently transfused, this should be noted; it is best to perform this study pretransfusion, if possible.